ArticleThe Journal of antimicrobial chemotherapy2023
Trends in antibiotic selection pressure generated in primary care and their association with sentinel antimicrobial resistance patterns in Europe.
Article in The Journal of antimicrobial chemotherapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 21 citations in OpenAlex.
- The global epidemiology of MRSA.JAC-antimicrobial resistance · 2026Review
- In silico discovery of thioglycoside analogues as donor-site inhibitors of glycosyltransferase LgtC.Scientific reports · 2026Article
- Cross-domain antimicrobial resistance in poultry farming: A One Health assessment of antimicrobial use and multidrug resistance in Kiambu County, Kenya.Veterinary world · 2026Article
- Fingerprinting PCR Reveals Potential Dissemination of Multidrug Efflux System Genes and Antimicrobial Resistance inInternational journal of microbiology · 2026Article
- Results from the Survey of Antibiotic Resistance (SOAR) 2018-21 in Italy and Spain: data based on CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints.The Journal of antimicrobial chemotherapy · 2025Article
- Routine data registries as a basis to analyse and improve the quality of antimicrobial prescription in primary care.BMC primary care · 2025Article
- Appropriateness of antibiotic use in nursing homes for suspected urinary tract infections: comparison across five European countries.European geriatric medicine · 2025Article
- Profiling of Pharmaceutical Sludge Microbiome, Resistome and Secondary Metabolites Using Metagenomics.Indian journal of microbiology · 2025Article
- In Silico Identification of Potential Clovibactin-like Antibiotics Binding to Unique Cell Wall Precursors in Diverse Gram-Positive Bacterial Strains.International journal of molecular sciences · 2025Article
- Observational study of antibiotic prescribing patterns by age and sex in primary care in England: why we need to take this variation into account to evaluate antibiotic stewardship and predict AMR variation.JAC-antimicrobial resistance · 2025Article
- Seven-year surveillance of antimicrobial resistance in respiratory pathogens at a Ugandan referral hospital: Emerging trends and stewardship priorities.African journal of thoracic and critical care medicine · 2025Article
- Change in Diagnosis ofAntibiotics (Basel, Switzerland) · 2024Review
- Insights from a Cross-Sectional Study on Knowledge, Attitudes and Behaviors Concerning Antibiotic Use in a Large Metropolitan Area: Implications for Public Health and Policy Interventions.Antibiotics (Basel, Switzerland) · 2023Article
- Assessment of drug utilization pattern of antimicrobial agents in hospitalized patients with Infectious Diseases: A cross-sectional study in the United Arab Emirates.Journal of advanced pharmaceutical technology & researchArticle
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWe studied trends in antibiotic prescribing by primary care and assessed the associations between generated antibiotic selection pressure (ASP) and the prevalence of sentinel drug-resistant microorganisms (SDRMs).
methodsThe volume of antibiotic prescribing in primary and hospital care expressed in DDD/1000 inhabitants per day and the prevalences of SDRMs in European countries where GPs act as gatekeepers were obtained from the European Centre for Disease Control ESAC-NET. Associations were tested between (i) DDD and (ii) the Antibiotic Spectrum Index (ASI) as a proxy indicator for ASP, and the prevalences of three SDRMs: MRSA, MDR Escherichia coli and Streptococcus pneumoniae resistant to macrolides.
resultsFourteen European countries were included. Italy, Poland and Spain had the highest prevalence of SDRMs and prescribed the highest volume of antibiotics in primary care (average 17 DDD per 1000 inhabitants per day), approximately twice that of countries with the lowest volumes. Moreover, the ASIs of these high antibiotic volume countries were approximately three times higher than those of the low-volume countries. Cumulative ASI showed the strongest association with a country's prevalence of SDRMs. The cumulative ASI generated from primary care was about four to five times higher than the cumulative ASI generated by hospital care.
conclusionsPrevalences of SDRMs are associated with the volume of antimicrobial prescribing and in particular broad-spectrum antibiotics in European countries where GPs act as gatekeepers. The impact of ASP generated from primary care on increasing antimicrobial resistance may be much larger than currently assumed.
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